Provider Demographics
NPI:1578305280
Name:MORALES, EDUARDO SR
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:MORALES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 S BIBB AVE UNIT REAR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-6344
Mailing Address - Country:US
Mailing Address - Phone:832-535-4557
Mailing Address - Fax:
Practice Address - Street 1:744 S BIBB AVE UNIT REAR
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6344
Practice Address - Country:US
Practice Address - Phone:832-535-4557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies